Six-hour surgery at SSKM gives patient new life

In a rare surgery, the SSKM Hospital has given a fresh lease of life to a septuagenarian, who had been suffering from Diaphragmatic Hernia (DH).

Diaphragmatic Hernia (DH) is a congenital defect in which there is an abnormal opening in the diaphragm. The diaphragm is a dome shaped muscular barrier between the chest and abdominal cavities. It separates one’s heart and lungs from abdominal organs like stomach, intestines, spleen and liver.

A diaphragmatic Hernia occurs when one of patient’s abdominal organs moves upward into his/her chest through a defect (opening) in the diaphragm. This kind of defect can present at birth or acquired later in life. It’s always a medical emergency and requires prompt surgery. DH is a rare defect that occurs while the baby is developing in the womb. The abdominal organs such as stomach, small intestine, spleen, part of liver and kidney may take up part of the chest cavity. This prevents the lung from growing normally.

Meerza Ayub Ali (72), a resident of Gopalpur village in Birbhum, visited the chest medicine department of the SSKM Hospital last month. After primary checkup he was shifted to the Cardio-Thorasic Vascular Surgery department of the hospital. The patient complained of serious respiratory problems. After the CT scan and X-ray, it was found that patient was suffering from DH. During the six-hour operation, doctors found that the left diaphragm of the patient was absent. When a patient’s diaphragm is absent or it does not develop it is called Diaphragmatic Agenesis which is a rare kind of disease.

Dr Arnab Maity, who was a member of the team of doctors who performed the surgery, said that in the operation theatre they came to know that the patients left diaphragm was absent, which is called a “Diaphragmatic Agenesis” in medical terminology. It is rare kind of disease as per the medical journal. “It was never easy to separate the organs that moved into thoracic cavity as it may damage the heart and lungs. We opened the chest and removed the organs from the thoracic cavity and placed them in abdominal cavity. Then created an artificial diaphragm made of prolene mesh which will separate the two cavities,” Dr Maity said.

The other doctors in the team were Dr Ansuman Mondal and Dr Kakoli Ghosh.

According to the Indian Journal of Chest Diseases and Allied Sciences, Diaphragmatic Agenesis, unilateral or bilateral is a rare occurrence among adults. While traumatic diaphragmatic defects or congenital defects such as posterio-lateral Bochdalek’s or anterior Morgagni’s hernia are well known, it is debatable whether agenesis of the diaphragm is a separate clinical entity rather than being a variant of diaphragmatic hernia. The patient was released from the hospital after his health condition improved.